Soussi Oumama, Chraibi Hamza, Es-Sebbani Sanae, Ech-Cherif El Kettani Omar, Bakamel Lamyaa, Massri Emad, Nesnassi Mounir, Leghlimi Hasnaa, Lachhab Fadoua, Tribak Mohammed, Fellat Rokya, Bensouda Adil, Bendagha Nesma, Soufiani Aida, Moughil Said
Cardiology A Department, Ibn Sina Hospital, Mohammed V University, Bettouga Street, Rabat 10000, Morocco.
Cardiovascular Surgery B Department, Ibn Sina Hospital, Mohammed V University, Bettouga Street, Rabat 10000, Morocco.
Radiol Case Rep. 2024 Feb 28;19(5):1975-1979. doi: 10.1016/j.radcr.2024.02.027. eCollection 2024 May.
Mitral valve masses are uncommon. These tumors and tumor-like lesions may have similar morphological and clinical characteristics, but different outcomes. Unlike valvular tumors, caseous calcification of the mitral annulus (CCMA) is a benign degenerative disorder, commonly misdiagnosed, thus differentiating it from other mitral valve masses is important to avoid unnecessary surgery. Multimodality imaging can prove a valuable tool for definitive diagnosis. We present a case of a 72-year-old female patient, with coronary artery disease, referred for angina symptoms. Echocardiography detected a mass in the mitral valve annulus. Cardiac magnetic resonance imaging showed a mobile mass respecting the myocardium suggestion an atypical papillary fibroelastoma and surgery was indicated. However, the definitive diagnosis, after histological examination, was CCMA. The aim of this case report is to illustrate the difficulty in differentiating between mitral valve masses and the repercussion on the subsequent management, emphasizing the pivotal role of multimodality imaging.
二尖瓣肿物并不常见。这些肿瘤及肿瘤样病变可能具有相似的形态学和临床特征，但预后不同。与瓣膜肿瘤不同，二尖瓣环干酪样钙化（CCMA）是一种良性退行性疾病，常被误诊，因此将其与其他二尖瓣肿物区分开来对于避免不必要的手术很重要。多模态成像可成为明确诊断的宝贵工具。我们报告一例72岁患有冠状动脉疾病的女性患者，因心绞痛症状前来就诊。超声心动图检测到二尖瓣环有一个肿物。心脏磁共振成像显示一个与心肌分界的活动肿物，提示为非典型乳头状纤维弹性瘤，遂建议手术。然而，组织学检查后的最终诊断为CCMA。本病例报告的目的是说明区分二尖瓣肿物的困难以及对后续治疗的影响，强调多模态成像的关键作用。
